Definition:

• Peripheral arterial disease is a term used to describe a cool solution of blood follow non coronary arteries and for the purpose of this section of the text is limited to the lower extremities.

• Most PAD occurs in the pelvis and legs.

• Peripheral vascular disease is a term that include diseases of the veins.

• PAD has been used by some to describe on on coronary atherosclerotic disease.

     Epidemiology:

• The prevalence of the condition increased with age.

• Prevalence of period of 2% to 3% by age 50 and approximately 20% by age 75 .

• Study found that 10% of the individuals with has claudication  50% had a typical leg pain and 40% had no leg pain associated with physical activity.

• Strong association between vascular diseases and damage to the coronary disease is leading to mortality.

• Risk factor for the development of are important to the development of PAD and are target for treatment.

• The most influential independent risk factors for development and progression or cigarette smoking and diabetes mellitus.

• In smokers PAD development is increased to 2 to 5 times.

• Smokers  also are 8 to 10 times more likely to develop intermittent claudication.

• Diabetic men have a higher rate of claudication than any other group.

• Diabetes in women eliminates the protective effect of estrogen so that their risk is elevated to that of men with similar risk profiles.

• While dyslipidemia and hypertension are important and do increased risk after they do not appear to be as influential as diabetes and cigarette smoking.

• The effect of hypertension on PAD appears to be much more subdued than the effect in the cerebral or coronary arteries.

     Pathophysiology:

• An inflammatory response precedes the plaque with subsequent embolus formation.

• The presence of PAD is also an indicator of ischemic diseases in other vascular bed, thus the risk of MI, stroke, unstable angina and sudden cardiac death is increased in patients.

• There are some small difference between the pathophysiology of PAD and that IHD.

• While thrombosis is known to play a critical role in all acute ischemic incident, it has been postulated that it has an even more important role in acute ischemic events in those with PAD.

• In response to ischemic, collateral vessel will be developed to allow some blood flow.

• The extent to which these vessels are formed and their contribution to functions seem to be determined to a great degree by the region in which the ischemia occurs.

• Patient with PAD will eventually suffer from the denervation of affected muscle tissues.

• The ischemia of tissue over time will cause this damage which is thought to be mediated by oxidative damage.

• The damage of denervation and alteration in muscle fibre type will reduce muscle function.

• There is additional evidence of abnormal muscle cell metabolism in affected tissues.

• Mitochondrial expressions increased in patients with PAD.

• While this is not uncommon to condition that a mitochondrial l function, the implication is that activities inside the muscle lead to its dysfunction.

• Accumulation of metabolic intermediates and products of incomplete metabolism show state of metabolic disorder inside the muscle

• Lactate levels at rest and during light workload are elevated beyond that which might be attributable to low blood oxygen supply.

• The electron transport chain suffer extensive oxidative damage as a result of PAD.
• Muscle tissues from PAD patient shows specific defect in the enzymes of the electron transport chain.

• This damage can lead to increase reactive oxygen species formation and may further metabolic injury.

• In addition the increase free radical production can contribute to endothelial injury.

• PAD can cause ulceration of the lower leg.

• Ulceration is defined as a non-healing break in the skin.

• The ischemic condition cause of breakdown of tissue, forming the  ulcer. The arterial ulcer associated with PAD commonly occur on the foot or toes.

• The most influential independent risk factor for development and progression are cigarette smoking and diabetes mellitus

What is the most common arterial disease?

What are example of peripheral vascular diseases?

Which disorder can caused arterial peripheral disease?

Ischemic heart ❤️ disease

 Nutrition therapy for Atherosclerosis: